2006, 06-13 Permit App 06002296 Plumbing ReversalSgokane
Y
Cornmtntity Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)68S-0037
tiv.-w.spokanevallev.ort.com
PIumbing Permit Application
SITE ADDRESS:
n Commercial
PERMIT NUMBER: - n
PERMIT FEE:
Residential
Building owner
.
Name:
Phone:
Fax:
Address:
City. State:
Zip:
Contractor . .
, .
Name:
Phone:
Fax:
Address:
City : State:
Zip:
License No:
City Business License No:
.Contact
:.. .
=, '
, t,„
„,
,, ; r ; -�
Name:
Phone:
D
DESCRIPTION OF WORK
t OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
S6.DD
=
4
SHOWERS (PER TRAP)
BATH, STALL ON -SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY. JANITOR, PHOTO.
X-RAY. FOOD. PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
B
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS. SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA CASE. COIL TRENCH, CONDENSATE
X
S5.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS. DRINKING
X
$6.0D
14
WATER PIPING/DRAIN-IN WASTE,
VENT. PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
/r i iJ
15
SEWAGE EJECTOR
GRINDER. SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER. CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS. TANKS. BOILERS
X
$6.D0
=
13
INTERCEPTORS
GREASE TRAP. SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS. OXYGEN
X
S6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
'
21
PRIVATE SEWAGE DISPOSAL/SYS
X
S20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
815A0
=
•
METHOD OF PAYMENT:
SUBTOTAL
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00 j
Card# EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
7,
REVISED S26/05
SPkane
�'U�iley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)638-0036 FAX: (509)638-0037
Community Development ww,x.,5Dokanevallev.ore.com
Mechanical Permit Application
PERMIT NUMBER
PERMIT FEE:
❑ Commercial n Residential
SITE ADDRESS:,,-, , ��' l / f� ' r T L f I? c�
Building owner
Name:
•
Phone: Fax:
Address: )
City ^ State:
Zip:
i�
Cantractor _ "..., ...
/�
/ ;
-
.1• r ' / :...
!. \
i
Name: T ,i• r
r/
/i>' SGr-
Phone: g� l-7' y 6/ Fax:
j
/"
Address: l 4/
r
pc/,.. „ 1„.1 c-'
City. Sate:
Zip:
1
License Na:
v
City Business License No:
\;
1
Contact . , ..
..•...,,
,.. i� .,..,�.,
•
� . ... ....,,:
..,.
...
.,.� :'
;.,.
Name:
Phone: // /
1'
DESCRIPTION OF WORK
#OFU�I1T.S X
cosh' \ = TOTAL AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
FUEL BURNING APPLIANCE
FUEL BURNING APPLIANCE
UNLISTED APPLIANCE (Additional Fee)
UNLISTED APPLIANCE (Additional Fee)
USED APPLIANCE (WSEC min. AFUE rating)
USED APPLIANCE (WSEC min. AFUE rating)
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOI LER/REFRI GERATI ON
BOILER/REFRIGERATION
GAS LOG. GAS INSERT. GAS FIREPLACE
RANGE
DRYER
FUEL BURNING WATER HEATER
MISC. FUEL BURNING APPLIANCE
GAS PIPING (each outlet) / 1
VENTILATING FANS
DUCT SYSTEMS
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include(du
EVAPORATIVE COOLERS
TYPE! HOOD
TYPE II HOOD
HEAT PUMP/AIR CONDITIONER
AIR CONDITIONER
AIR CONDff1ONER
AIR CONDITIONER
AIR CONDITIONER
LPG STORAGE TANK
1J
WOOD OR PELLET STOVE/INSERT
WOOD STOVE - FREE STANDING
REPAIR & ADDf11ONS
VENTILATION SYSTEMS
VENTILATION MECHANICAL EXHAUST
INCINERATOR - RESIDENCE
INCINERATOR - COMMERCIAL
METHOD OF PAYMENT:
❑CASH D CHECK ❑ VISA ❑ MC
CARD #:
AUTHORIZED SIGNATURE:
Equal to or less than 100,000
More than 100,000
Equal to or less than 400.000
More than 400.000
Equal to or less than 400.000
More than 400,000
1 -100M BTU
101-500M BTU
501- 1,000M BTU
1.001- 1,750M BTU
More than 1.750M/BTU
F
Equaito or less than 10,000 CFM
Greater%tfian 10.000 CFM
\0-3TON
3- 5 TON
15-30 T9UJ
30-50 TON
More than 50 TON
DATE
EXPIRES:
X $12.iD
$50.00 =
\1C $1D0.00
X\ ` ' •�to =
3100.0' ,-
\X $12.00
X\,
. $ '.00
X $ .
$35.0D _
X� $60.00
X $10.00 =
X $10.00 =
X $10.00 =
x S10.o0
$10.00
X $10.00 =
X $10.00
515.00
X $10.00
X 550.00
X $10.00
X $12.00 =
X $20.00 =
X $25.00
$35.00
X $60.00 =
X $10.00 =
X $10.00
X $25.00
X $15.00 =
X $12.00 =
X S12.00 =
X $19.00 =
X $22.00
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
$35.00
REVISED 8rz6r05